{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:24:01Z","timestamp":1792783441324,"version":"4.5.0"},"reference-count":64,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":83,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 degli Studi di Firenze","id":[{"id":"https:\/\/ror.org\/04jr1s763","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Aging Clin Exp Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dementia poses major challenges for public health and care systems, with family caregivers serving as the primary source of support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study explored the perceived needs, resources, and meanings attributed to the caregiving experience by family caregivers of people with dementia in a community-based setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An exploratory qualitative study was conducted using individual semi-structured interviews at a community health center. Sociodemographic and care-related information was collected, and four standardized questionnaires were administered for descriptive contextual purposes only. Qualitative data were analysed thematically with a two-phase approach, starting from an existing framework on meaning-making and using a secondary categorization for defining a conceptual model of barriers and resources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-five caregivers participated in the study. Levels of psychological distress and caregiver burden indicated emotional strain. Qualitative analysis identified three main themes and seven subthemes: (1) Complicated demands and healthcare interactions, including management of complex care needs and interaction with services; (2) Familial and relational dynamics, encompassing changes in family and social relationships, and shifts in reciprocity and role redefinition; and (3) Coping strategies and identity transformation, involving care as a source of personal meaning, sense of caregiving competence, and personal transformation. A conceptual model highlighted interconnected barriers and resources across individual, relational, and structural levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The identified themes advance understanding of caregivers\u2019 lived experiences and the interplay between individual, relational, and structural factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study highlights the importance of considering caregivers\u2019 coping strategies, health literacy, and resources through dedicated community-based interventions aimed at promoting their well-being and enhancing dementia care sustainability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40520-026-03436-x","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:57:01Z","timestamp":1783054621000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Needs, resources, and barriers among family caregivers of people with dementia: a qualitative study"],"prefix":"10.1007","volume":"38","author":[{"given":"Chiara","family":"Milani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Biagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachele","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorenza","family":"Wetzell Cabrera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diletta","family":"Buresta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Del Riccio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Barucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Benvenuti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Baggiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Naldini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Lorini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guglielmo","family":"Bonaccorsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"3436_CR1","volume-title":"World Alzheimer Report 2023: reducing dementia risk: never too early, never too late","author":"Alzheimer\u2019s Disease International","year":"2023","unstructured":"Alzheimer\u2019s Disease International (2023) World Alzheimer Report 2023: reducing dementia risk: never too early, never too late. Alzheimer\u2019s Disease International, London"},{"key":"3436_CR2","unstructured":"World Health Organization Dementia carer support services [Internet]. Geneva: WHO; n.d. Available from: https:\/\/www.who.int\/data\/gho\/data\/themes\/global-dementia-observatory-gdo\/dementia-carer-support-services"},{"issue":"10","key":"3436_CR3","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.2105\/AJPH.2018.304573","volume":"108","author":"KM Rabarison","year":"2018","unstructured":"Rabarison KM, Bouldin ED, Bish CL et al (2018) The economic value of informal caregiving for persons with dementia: results from 38 states, the District of Columbia, and Puerto Rico, 2015 and 2016 BRFSS. Am J Public Health 108(10):1370\u20131377. https:\/\/doi.org\/10.2105\/AJPH.2018.304573","journal-title":"Am J Public Health"},{"issue":"4","key":"3436_CR4","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1002\/hec.4928","volume":"34","author":"J Costa-Font","year":"2025","unstructured":"Costa-Font J, Vilaplana-Prieto C (2025) The hidden value of adult informal care in Europe. Health Econ 34(4):791\u2013812. https:\/\/doi.org\/10.1002\/hec.4928","journal-title":"Health Econ"},{"key":"3436_CR5","unstructured":"Alzheimer\u2019s Association. Alzheimer\u2019s disease facts and figures: includes a special report on Alzheimer\u2019s detection in the primary care setting: connecting patients and physicians (2019) [Internet] Available from: https:\/\/www.alz.org\/alzheimers-dementia\/facts-figures"},{"key":"3436_CR6","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1186\/s12877-016-0298-y","volume":"16","author":"A Goren","year":"2016","unstructured":"Goren A, Montgomery W, Kahle-Wrobleski K, Nakamura T, Ueda K (2016) Impact of caring for persons with Alzheimer\u2019s disease or dementia on caregivers\u2019 health outcomes: findings from a community-based survey in Japan. BMC Geriatr 16:122. https:\/\/doi.org\/10.1186\/s12877-016-0298-y","journal-title":"BMC Geriatr"},{"issue":"3","key":"3436_CR7","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/s11136-015-1110-x","volume":"25","author":"TH V\u00e4lim\u00e4ki","year":"2016","unstructured":"V\u00e4lim\u00e4ki TH, Martikainen JA, Hongisto K, V\u00e4\u00e4t\u00e4inen S, Sintonen H, Koivisto AM (2016) Impact of Alzheimer\u2019s disease on the family caregiver\u2019s long-term quality of life: results from an ALSOVA follow-up study. Qual Life Res 25(3):687\u2013697. https:\/\/doi.org\/10.1007\/s11136-015-1110-x","journal-title":"Qual Life Res"},{"key":"3436_CR8","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12877-016-0280-8","volume":"16","author":"KJ Gilhooly","year":"2016","unstructured":"Gilhooly KJ, Gilhooly MLM, Sullivan MP, McIntyre A, Wilson L, Harding E et al (2016) A meta-review of stress, coping and interventions in dementia and dementia caregiving. BMC Geriatr 16:106. https:\/\/doi.org\/10.1186\/s12877-016-0280-8","journal-title":"BMC Geriatr"},{"issue":"5","key":"3436_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/13607863.2015.1109059","volume":"21","author":"M Ma","year":"2017","unstructured":"Ma M, Dorstyn D, Ward L, Prentice S (2017) Alzheimer\u2019s disease and caregiving: a meta-analytic review comparing the mental health of primary carers to controls. Aging Ment Health 21(5):1\u201311. https:\/\/doi.org\/10.1080\/13607863.2015.1109059","journal-title":"Aging Ment Health"},{"issue":"7","key":"3436_CR10","doi-asserted-by":"publisher","first-page":"731","DOI":"10.3390\/healthcare13070731","volume":"13","author":"E Cejalvo","year":"2025","unstructured":"Cejalvo E, Mart\u00ed-Vilar M, Gisbert-P\u00e9rez J, Badenes-Ribera L (2025) Stress as a risk factor for informal caregiver burden. Healthc (Basel) 13(7):731. https:\/\/doi.org\/10.3390\/healthcare13070731","journal-title":"Healthc (Basel)"},{"issue":"11","key":"3436_CR11","first-page":"892","volume":"26","author":"S Dawood","year":"2016","unstructured":"Dawood S (2016) Caregiver burden, quality of life and vulnerability towards psychopathology in caregivers of patients with dementia\/Alzheimer\u2019s disease. J Coll Physicians Surg Pak 26(11):892\u2013895","journal-title":"J Coll Physicians Surg Pak"},{"issue":"5","key":"3436_CR12","doi-asserted-by":"publisher","first-page":"4328","DOI":"10.3390\/ijerph20054328","volume":"20","author":"SC Duplantier","year":"2023","unstructured":"Duplantier SC, Williamson FA (2023) Barriers and facilitators of health and well-being in informal caregivers of dementia patients: a qualitative study. Int J Environ Res Public Health 20(5):4328. https:\/\/doi.org\/10.3390\/ijerph20054328","journal-title":"Int J Environ Res Public Health"},{"key":"3436_CR13","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/1471-2458-12-80","volume":"12","author":"K S\u00f8rensen","year":"2012","unstructured":"S\u00f8rensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z et al (2012) Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health 12:80. https:\/\/doi.org\/10.1186\/1471-2458-12-80","journal-title":"BMC Public Health"},{"issue":"10452","key":"3436_CR14","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1016\/S0140-6736(24)01296-0","volume":"404","author":"G Livingston","year":"2024","unstructured":"Livingston G, Huntley J, Liu KY, Costafreda SG, Selb\u00e6k G, Alladi S et al (2024) Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. Lancet 404(10452):572\u2013628. https:\/\/doi.org\/10.1016\/S0140-6736(24)01296-0","journal-title":"Lancet"},{"key":"3436_CR15","doi-asserted-by":"publisher","first-page":"104848","DOI":"10.1016\/j.ijnurstu.2024.104848","volume":"158","author":"S Chen","year":"2024","unstructured":"Chen S, Lou VWQ, Leung R, Yu DSF (2024) Meaning-making of dementia caregiving: a systematic review of qualitative studies. Int J Nurs Stud 158:104848. https:\/\/doi.org\/10.1016\/j.ijnurstu.2024.104848","journal-title":"Int J Nurs Stud"},{"issue":"3","key":"3436_CR16","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/j.archger.2015.03.002","volume":"60","author":"C de Labra","year":"2015","unstructured":"de Labra C, Mill\u00e1n-Calenti JC, Buj\u00e1n A, N\u00fa\u00f1ez-Naveira L, Jensen AM, Peersen MC et al (2015) Predictors of caregiving satisfaction in informal caregivers of people with dementia. Arch Gerontol Geriatr 60(3):380\u2013388. https:\/\/doi.org\/10.1016\/j.archger.2015.03.002","journal-title":"Arch Gerontol Geriatr"},{"key":"3436_CR17","unstructured":"Agenzia Regionale di Sanit\u00e0 della Toscana. Preziosi ma invisibili: i caregiver familiari in Toscana. Documento ARS 114. Firenze: ARS Toscana (2021) [Internet] Available from: https:\/\/www.ars.toscana.it\/images\/pubblicazioni\/Collana_ARS\/2021\/Doc_114_preziosi\/114_Preziosi_ma_invisibili_2021_rev.pdf. Accessed July 10, 2025"},{"issue":"4","key":"3436_CR18","doi-asserted-by":"publisher","first-page":"457","DOI":"10.3390\/bs15040457","volume":"15","author":"D Neal","year":"2025","unstructured":"Neal D, Bartels SL, Berdai Chaouni S, Caprioli T, Comas-Herrera A, Chattat R et al (2025) Effective for whom? A review of psychological and social intervention recommendations in European dementia care guidelines through the lenses of social health and intersectionality. Behav Sci (Basel) 15(4):457. https:\/\/doi.org\/10.3390\/bs15040457","journal-title":"Behav Sci (Basel)"},{"issue":"2","key":"3436_CR19","doi-asserted-by":"publisher","first-page":"igy015","DOI":"10.1093\/geroni\/igy015","volume":"2","author":"JE Gaugler","year":"2018","unstructured":"Gaugler JE, Reese M, Mittelman MS (2018) The effects of a comprehensive psychosocial intervention on secondary stressors and social support for adult child caregivers of persons with dementia. Innov Aging 2(2):igy015. https:\/\/doi.org\/10.1093\/geroni\/igy015","journal-title":"Innov Aging"},{"issue":"1","key":"3436_CR20","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1186\/s12877-025-05986-7","volume":"25","author":"J Yang","year":"2025","unstructured":"Yang J, Fearn C, John A, Hoare S, Chang S, Zammitt D et al (2025) A systematic review and thematic synthesis on the experiences of accessing and attending psychological therapy for informal carers of people living with dementia. BMC Geriatr 25(1):353. https:\/\/doi.org\/10.1186\/s12877-025-05986-7","journal-title":"BMC Geriatr"},{"key":"3436_CR21","doi-asserted-by":"publisher","first-page":"1216814","DOI":"10.3389\/fpubh.2023.1216814","volume":"11","author":"C Milani","year":"2023","unstructured":"Milani C, Naldini G, Baggiani L, Nerattini M, Bonaccorsi G (2023) How to promote changes in primary care? The Florentine experience of the House of Community. Front Public Health 11:1216814. https:\/\/doi.org\/10.3389\/fpubh.2023.1216814","journal-title":"Front Public Health"},{"issue":"9","key":"3436_CR22","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","volume":"89","author":"BC O\u2019Brien","year":"2014","unstructured":"O\u2019Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA (2014) Standards for reporting qualitative research (SRQR): a synthesis of recommendations. Acad Med 89(9):1245\u20131251. https:\/\/doi.org\/10.1097\/ACM.0000000000000388","journal-title":"Acad Med"},{"issue":"6","key":"3436_CR23","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1177\/1049909110393331","volume":"28","author":"J Andruccioli","year":"2011","unstructured":"Andruccioli J, Russo MM, Bruschi A, Pedrabissi L, Sarti D, Monterubbianesi MC et al (2011) Caregiver evaluation in hospice: application of a semi-structured interview. Am J Hosp Palliat Care 28(6):393\u2013397. https:\/\/doi.org\/10.1177\/1049909110393331","journal-title":"Am J Hosp Palliat Care"},{"key":"3436_CR24","unstructured":"World Health Organization (1998) WHO-5 Well-Being Index (Italian version). Psychiatric Research Unit, WHO Collaborating Centre for Mental Health, Copenhagen"},{"issue":"1","key":"3436_CR25","doi-asserted-by":"publisher","first-page":"10","DOI":"10.4415\/ANN_19_01_04","volume":"55","author":"C Lorini","year":"2019","unstructured":"Lorini C, Lastrucci V, Mantwill S, Vettori V, Bonaccorsi G, Florence Health Literacy Research Group (2019) Measuring health literacy in Italy: a validation study of the HLS-EU-Q16 and of the HLS-EU-Q6 in Italian language, conducted in Florence and its surroundings. Ann Ist Super Sanita 55(1):10\u201318. https:\/\/doi.org\/10.4415\/ANN_19_01_04","journal-title":"Ann Ist Super Sanita"},{"issue":"3","key":"3436_CR26","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","volume":"33","author":"PF Lovibond","year":"1995","unstructured":"Lovibond PF, Lovibond SH (1995) The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 33(3):335\u2013343. https:\/\/doi.org\/10.1016\/0005-7967(94)00075-U","journal-title":"Behav Res Ther"},{"key":"3436_CR27","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.comppsych.2015.04.005","volume":"60","author":"G Bottesi","year":"2015","unstructured":"Bottesi G, Ghisi M, Alto\u00e8 G, Conforti E, Melli G, Sica C (2015) The Italian version of the Depression Anxiety Stress Scales-21: factor structure and psychometric properties on community and clinical samples. Compr Psychiatry 60:170\u2013181. https:\/\/doi.org\/10.1016\/j.comppsych.2015.04.005","journal-title":"Compr Psychiatry"},{"key":"3436_CR28","doi-asserted-by":"publisher","unstructured":"Novak M, Guest C (1989) Application of a multidimensional caregiver burden inventory. Gerontologist 29(6):798\u2013803. https:\/\/doi.org\/10.1093\/geront\/29.6.798","DOI":"10.1093\/geront\/29.6.798"},{"key":"3436_CR29","doi-asserted-by":"publisher","unstructured":"Marvardi M, Mattioli P, Spazzafumo L, Mastriforti R, Rinaldi P, Polidori MC et al (2005) The Caregiver Burden Inventory in evaluating the burden of caregivers of elderly demented patients: results from a multicenter study. Aging Clin Exp Res. 17(1) https:\/\/doi.org\/10.1007\/BF03337720","DOI":"10.1007\/BF03337720"},{"issue":"4","key":"3436_CR30","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1017\/S1041610206003462","volume":"18","author":"M Pinquart","year":"2006","unstructured":"Pinquart M, S\u00f6rensen S (2006) Helping caregivers of persons with dementia: which interventions work and how large are their effects? Int Psychogeriatr 18(4):577\u2013595. https:\/\/doi.org\/10.1017\/S1041610206003462","journal-title":"Int Psychogeriatr"},{"issue":"22","key":"3436_CR31","doi-asserted-by":"publisher","first-page":"3277","DOI":"10.2169\/internalmedicine.0911-22","volume":"62","author":"Y Goto","year":"2023","unstructured":"Goto Y, Morita K, Suematsu M, Imaizumi T, Suzuki Y, Caregiver Burdens (2023) Health Risks, Coping and Interventions among Caregivers of Dementia Patients: A Review of the Literature. Intern Med 62(22):3277\u20133282. https:\/\/doi.org\/10.2169\/internalmedicine.0911-22","journal-title":"Intern Med"},{"issue":"2","key":"3436_CR32","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1007\/s41999-024-01150-3","volume":"16","author":"R Liu","year":"2025","unstructured":"Liu R, Peak K, Trubits E, Qui\u00f1ones AR (2025) Caregiving outcomes among informal caregivers of persons with multimorbidity and dementia: a scoping review. Eur Geriatr Med 16(2):485\u2013524. https:\/\/doi.org\/10.1007\/s41999-024-01150-3","journal-title":"Eur Geriatr Med"},{"issue":"1","key":"3436_CR33","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s40520-022-02271-0","volume":"35","author":"C Lorini","year":"2023","unstructured":"Lorini C, Buscemi P, Mossello E et al (2023) Health literacy of informal caregivers of older adults with dementia: results from a cross-sectional study conducted in Florence (Italy). Aging Clin Exp Res 35(1):61\u201371. https:\/\/doi.org\/10.1007\/s40520-022-02271-0","journal-title":"Aging Clin Exp Res"},{"key":"3436_CR34","doi-asserted-by":"publisher","unstructured":"Bingham AJ (2023) From data management to actionable findings: a five-phase process of qualitative data analysis. Int J Qual Methods 22. https:\/\/doi.org\/10.1177\/16094069231183620","DOI":"10.1177\/16094069231183620"},{"issue":"10","key":"3436_CR35","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1001\/jama.2014.304","volume":"311","author":"RD Adelman","year":"2014","unstructured":"Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS (2014) Caregiver burden: a clinical review. JAMA 311(10):1052\u20131060. https:\/\/doi.org\/10.1001\/jama.2014.304","journal-title":"JAMA"},{"issue":"1","key":"3436_CR36","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1186\/s12912-024-02293-1","volume":"23","author":"J Gu","year":"2024","unstructured":"Gu J, Sun X, Shi Y, Wang S, Wang P, Liu L et al (2024) The hidden costs of informal caregiving: a concept analysis. BMC Nurs 23(1):617. https:\/\/doi.org\/10.1186\/s12912-024-02293-1","journal-title":"BMC Nurs"},{"issue":"8","key":"3436_CR37","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1007\/s10198-025-01776-5","volume":"26","author":"SA Keramat","year":"2025","unstructured":"Keramat SA, Sarker PM, Comans T, Brooks D, Dissanayaka NN (2025) Deterioration of health-related quality of life: the hidden health burden of informal caregiving. Eur J Health Econ 26(8):1415\u20131438. https:\/\/doi.org\/10.1007\/s10198-025-01776-5 Epub 2025 Apr 17. PMID: 40240675; PMCID: PMC12572017","journal-title":"Eur J Health Econ"},{"key":"3436_CR38","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.ijnurstu.2017.09.011","volume":"77","author":"G Tatangelo","year":"2018","unstructured":"Tatangelo G, McCabe M, Macleod A, You E (2018) I just don\u2019t focus on my needs: the unmet health needs of partner and offspring caregivers of people with dementia\u2014a qualitative study. Int J Nurs Stud 77:8\u201314. https:\/\/doi.org\/10.1016\/j.ijnurstu.2017.09.011","journal-title":"Int J Nurs Stud"},{"key":"3436_CR39","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00516-4","volume-title":"World report on ageing and health","author":"World Health Organization","year":"2015","unstructured":"World Health Organization (2015) World report on ageing and health. World Health Organization, Geneva, Switzerland. https:\/\/doi.org\/10.1016\/S0140-6736(15)00516-4"},{"issue":"2","key":"3436_CR40","doi-asserted-by":"publisher","first-page":"213","DOI":"10.7416\/ai.2022.2534","volume":"35","author":"G Bonaccorsi","year":"2023","unstructured":"Bonaccorsi G, Milani C, Giorgetti D, Setola N, Naldi E, Manzi F et al (2023) Impact of built environment and neighborhood on promoting mental health, well-being, and social participation in older people: an umbrella review. Ann Ig 35(2):213\u2013239. https:\/\/doi.org\/10.7416\/ai.2022.2534","journal-title":"Ann Ig"},{"issue":"9","key":"3436_CR41","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1080\/13607863.2019.1617238","volume":"24","author":"I Rippon","year":"2020","unstructured":"Rippon I, Quinn C, Martyr A, Morris R, Nelis SM, Jones IR et al (2020) The impact of relationship quality on life satisfaction and well-being in dementia caregiving dyads: findings from the IDEAL study. Aging Ment Health 24(9):1411\u20131420. https:\/\/doi.org\/10.1080\/13607863.2019.1617238","journal-title":"Aging Ment Health"},{"issue":"8","key":"3436_CR42","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1093\/geront\/gnaa178","volume":"61","author":"MJ Wylie","year":"2021","unstructured":"Wylie MJ, Kim K, Liu Y, Zarit SH (2021) Taking a break: daily respite effects of adult day services as objective and subjective time away from caregiving. Gerontologist 61(8):1231\u20131240. https:\/\/doi.org\/10.1093\/geront\/gnaa178","journal-title":"Gerontologist"},{"issue":"19","key":"3436_CR43","doi-asserted-by":"publisher","first-page":"3771","DOI":"10.3390\/ijerph16193771","volume":"16","author":"G Bonaccorsi","year":"2019","unstructured":"Bonaccorsi G, Pieralli F, Innocenti M, Milani C, Del Riccio M, Donzellini M et al (2019) Health literacy among non-familial caregivers of older adults: a study conducted in Tuscany (Italy). Int J Environ Res Public Health 16(19):3771. https:\/\/doi.org\/10.3390\/ijerph16193771","journal-title":"Int J Environ Res Public Health"},{"issue":"3","key":"3436_CR44","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1080\/13607860902879441","volume":"13","author":"M Braun","year":"2009","unstructured":"Braun M, Scholz U, Bailey B, Perren S, Hornung R, Martin M (2009) Dementia caregiving in spousal relationships: a dyadic perspective. Aging Ment Health 13(3):426\u2013436. https:\/\/doi.org\/10.1080\/13607860902879441","journal-title":"Aging Ment Health"},{"issue":"11","key":"3436_CR45","doi-asserted-by":"publisher","first-page":"1619","DOI":"10.1017\/S1041610218000303","volume":"30","author":"ER Conway","year":"2018","unstructured":"Conway ER, Watson B, Tatangelo G, McCabe M (2018) Is it all bleak? A systematic review of factors contributing to relationship change in dementia. Int Psychogeriatr 30(11):1619\u20131637. https:\/\/doi.org\/10.1017\/S1041610218000303","journal-title":"Int Psychogeriatr"},{"issue":"1","key":"3436_CR46","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1186\/s12877-019-1185-0","volume":"19","author":"N Greenwood","year":"2019","unstructured":"Greenwood N, Smith R (2019) Motivations for being informal carers of people living with dementia: a systematic review of qualitative literature. BMC Geriatr 19(1):169. https:\/\/doi.org\/10.1186\/s12877-019-1185-0","journal-title":"BMC Geriatr"},{"issue":"3","key":"3436_CR47","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1177\/0891988715588830","volume":"28","author":"L Roche","year":"2015","unstructured":"Roche L, Croot K, MacCann C, Cramer B, Diehl-Schmid J (2015) The role of coping strategies in psychological outcomes for frontotemporal dementia caregivers. J Geriatr Psychiatry Neurol 28(3):218\u2013228. https:\/\/doi.org\/10.1177\/0891988715588830","journal-title":"J Geriatr Psychiatry Neurol"},{"issue":"6","key":"3436_CR48","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1177\/08919887211060016","volume":"35","author":"J Caga","year":"2021","unstructured":"Caga J, Kiernan MC, Piguet O (2021) A systematic review of caregiver coping strategies in amyotrophic lateral sclerosis and frontotemporal dementia. J Geriatr Psychiatry Neurol 35(6):763\u2013777. https:\/\/doi.org\/10.1177\/08919887211060016","journal-title":"J Geriatr Psychiatry Neurol"},{"issue":"4","key":"3436_CR49","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1080\/08952841.2014.906873","volume":"26","author":"NR George","year":"2014","unstructured":"George NR, Steffen A (2014) Physical and mental health correlates of self-efficacy in dementia family caregivers. J Women Aging 26(4):319\u2013331. https:\/\/doi.org\/10.1080\/08952841.2014.906873","journal-title":"J Women Aging"},{"issue":"3","key":"3436_CR50","doi-asserted-by":"publisher","first-page":"182","DOI":"10.2185\/jrm.2022-039","volume":"18","author":"M Nishio","year":"2023","unstructured":"Nishio M, Sakanashi S, Uchida N, Oma S, Kimura H, Kukihara H et al (2023) Ability of older male caregivers to seek help when caring for a wife or mother with dementia living at home. J Rural Med 18(3):182\u2013188. https:\/\/doi.org\/10.2185\/jrm.2022-039","journal-title":"J Rural Med"},{"issue":"1","key":"3436_CR51","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1177\/1054773806295238","volume":"16","author":"YF Lu","year":"2007","unstructured":"Lu YF, Wykle M (2007) Relationships between caregiver stress and self-care behaviors in response to symptoms. Clin Nurs Res 16(1):29\u201343. https:\/\/doi.org\/10.1177\/1054773806295238","journal-title":"Clin Nurs Res"},{"issue":"1","key":"3436_CR52","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1037\/pag0000401","volume":"35","author":"ST Cheng","year":"2020","unstructured":"Cheng ST, Li KK, Losada A, Zhang F, Au A, Thompson LW et al (2020) The effectiveness of nonpharmacological interventions for informal dementia caregivers: an updated systematic review and meta-analysis. Psychol Aging 35(1):55\u201377. https:\/\/doi.org\/10.1037\/pag0000401","journal-title":"Psychol Aging"},{"issue":"2","key":"3436_CR53","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1093\/geront\/gnu177","volume":"55","author":"DL Roth","year":"2015","unstructured":"Roth DL, Fredman L, Haley WE (2015) Informal caregiving and its impact on health: a reappraisal from population-based studies. Gerontologist 55(2):309\u2013319. https:\/\/doi.org\/10.1093\/geront\/gnu177 Epub 2015 Feb 18. PMID: 26035608; PMCID: PMC6584119","journal-title":"Gerontologist"},{"key":"3436_CR54","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1186\/s12877-018-0896-y","volume":"18","author":"S Pihet","year":"2018","unstructured":"Pihet S, Kipfer S (2018) Coping with dementia caregiving: a mixed-methods study on feasibility and benefits of a psycho-educative group program. BMC Geriatr 18:209. https:\/\/doi.org\/10.1186\/s12877-018-0896-y","journal-title":"BMC Geriatr"},{"issue":"7","key":"3436_CR55","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1002\/gps.5095","volume":"34","author":"L Garand","year":"2019","unstructured":"Garand L, Morse JQ, ChiaRebecca L, Barnes J, Dadebo V, Lopez OL et al (2019) Problem-solving therapy reduces subjective burden levels in caregivers of family members with mild cognitive impairment or early-stage dementia: secondary analysis of a randomized clinical trial. Int J Geriatr Psychiatry 34(7):957\u2013965. https:\/\/doi.org\/10.1002\/gps.5095","journal-title":"Int J Geriatr Psychiatry"},{"issue":"9","key":"3436_CR56","doi-asserted-by":"publisher","first-page":"5447","DOI":"10.3390\/ijerph19095447","volume":"19","author":"HHM Lo","year":"2022","unstructured":"Lo HHM, Au A, Cho WV, Lau ENS, Wong JYH, Wong SYS et al (2022) Mindfulness-based intervention for caregivers of frail older Chinese adults: a study protocol. Int J Environ Res Public Health 19(9):5447. https:\/\/doi.org\/10.3390\/ijerph19095447","journal-title":"Int J Environ Res Public Health"},{"key":"3436_CR57","doi-asserted-by":"publisher","unstructured":"Semiatin AM, O\u2019Connor MK (2012) The relationship between self-efficacy and positive aspects of caregiving in Alzheimer\u2019s disease caregivers. Aging Ment Health.;16(6):683-8 . Epub 2012 Feb 24. PMID: 22360626 https:\/\/doi.org\/10.1080\/13607863.2011.651437. Epub 2012 Feb 24. PMID: 22360626","DOI":"10.1080\/13607863.2011.651437"},{"issue":"10","key":"3436_CR58","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1089\/acm.2009.0733","volume":"16","author":"BS Oken","year":"2010","unstructured":"Oken BS, Fonareva I, Haas M, Wahbeh H, Lane JB, Zajdel D, Amen A (2010) Pilot controlled trial of mindfulness meditation and education for dementia caregivers. J Altern Complement Med 16(10):1031\u20131038. https:\/\/doi.org\/10.1089\/acm.2009.0733 Epub 2010 Oct 7. PMID: 20929380; PMCID: PMC3110802","journal-title":"J Altern Complement Med"},{"issue":"10","key":"3436_CR59","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1002\/gps.2660","volume":"26","author":"LY Chien","year":"2011","unstructured":"Chien LY, Chu H, Guo JL, Liao YM, Chang LI, Chen CH et al (2011) Caregiver support groups in patients with dementia: a meta-analysis. Int J Geriatr Psychiatry 26(10):1089\u20131098. https:\/\/doi.org\/10.1002\/gps.2660","journal-title":"Int J Geriatr Psychiatry"},{"issue":"6","key":"3436_CR60","doi-asserted-by":"publisher","first-page":"373","DOI":"10.11124\/jbisrir-2015-2121","volume":"13","author":"J Lauritzen","year":"2015","unstructured":"Lauritzen J, Pedersen PU, S\u00f8rensen EE, Bjerrum MB (2015) The meaningfulness of participating in support groups for informal caregivers of older adults with dementia: a systematic review. JBI Database Syst Rev Implement Rep 13(6):373\u2013433. https:\/\/doi.org\/10.11124\/jbisrir-2015-2121","journal-title":"JBI Database Syst Rev Implement Rep"},{"key":"3436_CR61","unstructured":"Belluto M, Salmi V, Ziosi S (2022) [Internet] Il sostegno ai caregiver: integrazione multiprofessionale e innovazione nell\u2019area metropolitana bolognese. Working Paper 2WEL. Percorsi di Secondo Welfare; Available from: https:\/\/www.secondowelfare.it\/wp-content\/uploads\/2022\/12\/WP-2WEL_2_2022_Belluto_Salmi_Zios_sostegno-ai-caregiveri.pdf"},{"key":"3436_CR62","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12913-015-0875-3","volume":"15","author":"A Stephan","year":"2015","unstructured":"Stephan A, M\u00f6hler R, Renom-Guiteras A, Meyer G (2015) Successful collaboration in dementia care from the perspectives of healthcare professionals and informal carers in Germany: results from a focus group study. BMC Health Serv Res 15:208. https:\/\/doi.org\/10.1186\/s12913-015-0875-3 PMID: 26017697; PMCID: PMC4446073","journal-title":"BMC Health Serv Res"},{"issue":"5","key":"3436_CR63","doi-asserted-by":"publisher","first-page":"513","DOI":"10.7416\/ai.2024.2631","volume":"36","author":"C Milani","year":"2024","unstructured":"Milani C, Naldini G, Occhini G et al (2024) Enhancing Primary Health Care through Interprofessional education: Insights from a Training Workshop. Ann Ig 36(5):513\u2013524. https:\/\/doi.org\/10.7416\/ai.2024.2631","journal-title":"Ann Ig"},{"issue":"5","key":"3436_CR64","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/alz.13862","volume":"20","author":"Alzheimer\u2019s Association","year":"2024","unstructured":"Alzheimer\u2019s Association (2024) Mapping a better future for dementia care navigation. Alzheimers Dement 20(5):1\u2013102. https:\/\/doi.org\/10.1002\/alz.13862","journal-title":"Alzheimers Dement"}],"container-title":["Aging Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40520-026-03436-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-026-03436-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40520-026-03436-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:02:39Z","timestamp":1790258559000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40520-026-03436-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":64,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3436"],"URL":"https:\/\/doi.org\/10.1007\/s40520-026-03436-x","relation":{},"ISSN":["1720-8319"],"issn-type":[{"value":"1720-8319","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]},"assertion":[{"value":"12 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the principles of the Declaration of Helsinki. All participants are provided with detailed information about the study aims and procedures, and written informed consent was obtained before participation. Given that no audio recordings were collected, transcripts were prepared during the interviews and subsequently shared with participants to ensure accuracy and fidelity. Participants\u2019 anonymity and confidentiality were safeguarded throughout the research process. Ethical approval was obtained by the Ethics Committee of the Tuscany Region \u2013 sezione Area Vasta Centro, on 17.05.2024, version 1st.","order":2,"name":"Ethics","label":"Ethical considerations","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"196"}}